Republicans

Sometime next year, it is highly probable the U.S. Supreme Court will decide whether the federal government can force people to buy health insurance or pay a fine.

In addition to the landmark impact this ruling will have on the health care industry specifically, it also could sway the outcome of the 2012 elections -- from the Oval Office to other key legislative positions around the country. No matter what, the stakes are high. Even if the issue escapes scrutiny by the Supreme Court in 2012, it’s possible that when the Justices do address the merits of the case that a Republican administration will be in the White House – along with a Justice Department that no longer will defend the Patient Protection and Affordable Care Act (PPACA).

Over the summer, Congress will likely take a more incremental approach to addressing any amendments to the Patient Protection and Affordable Care Act (PPACA).[1] After the House sent a shock wave of “repeal” earlier in the year, things appear to be cooling down a little with the new mantra of “repair.”

Some changes to PPACA original requirements already have been made both at the legislative and regulatory levels. For example, the Republicans succeeded in repealing the infamous 1099 filing requirement earlier this spring -- albeit through a bipartisan vote and which was signed into law by President Obama.[2]

Further, some Republicans are now sending mixed messages as to what their next steps will be. Here is one example:

Battles continue to rage between House Republicans, Senate Democrats and the Obama Administration on a variety of financial and health care issues. As always, BenefitMall pledges to keep you up-to-date on the latest topics affecting the healthcare industry. Here are some brief snapshots of what is just around the corner.[1]

The Looming Debt Crisis

The U.S. debt reached the maximum allowed debt level on May 16, stretching to the ceiling of $14.3 trillion.[2] Both parties have been unable to reach an agreement to address the debt and federal spending problems, forcing the Department of Treasury (DOT) to take “extraordinary measures” by suspending the issuance of new debt and tapping two federal employee pension funds.[3] According to DOT, this will allow the government to continue functioning until August 2 when the tapped pension funds will be depleted.[4] Despite current grandstanding by all parties involved, a compromise must be reached by that date or the government will face another threat of shutdown.

Battles continue to rage between House Republicans, Senate Democrats and the Obama Administration on a variety of financial and health care issues. As always, BenefitMall pledges to keep you up-to-date on the latest topics affecting the healthcare industry. Here are some brief snapshots of what is just around the corner.[1]

The Looming Debt Crisis

The U.S. debt reached the maximum allowed debt level on May 16, stretching to the ceiling of $14.3 trillion.[2] Both parties have been unable to reach an agreement to address the debt and federal spending problems, forcing the Department of Treasury (DOT) to take “extraordinary measures” by suspending the issuance of new debt and tapping two federal employee pension funds.[3] According to DOT, this will allow the government to continue functioning until August 2 when the tapped pension funds will be depleted.[4] Despite current grandstanding by all parties involved, a compromise must be reached by that date or the government will face another threat of shutdown.

If you were able to attend our Legislative Webinar, we thank you for your participation. During the webinar, BenefitMall’s Executive Vice President, Michael Gomes, discussed the impact of the recent elections on Health Care Reform, including:

What does the new Republican Congress mean to Health Care Reform

Latest status on Medical Loss Ratio debate

The future of Health Care Exchanges

Amendments to the Grandfathered Plans

If you have any questions that were not addressed on the call, we encourage your questions below. Click the “Add new comment” link below to submit your feedback.

To view a copy of the PowerPoint presentation, please click on the “Presentations” tab located at the top right-hand corner of this webpage.

No matter who is in control of the White House or Congress, one bipartisan activity that will continue in the coming years is the fight against health care fraud. Both Democratic and Republican Administrations have supported a number of anti-fraud programs to identify criminal activities that hurt consumers and cost U.S. taxpayers dearly.

Recently, the U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) announced the launch of another round of initiatives to fight health care fraud, including hosting fraud summits in several cities.A HHS press release published on November 5th explains “(t)he summits are part of a larger effort on behalf of the Obama Administration to root-out waste, fraud, and abuse within the U.S. health care system.”In 2009, HHS reports that “anti-fraud efforts put $2.51 billion back in the Medicare Trust Fund resulting from civil recoveries, fines in criminal matters, and administrative recoveries.”

With all the hoopla this week about the Congressional lame duck session and anticipation over the 112nd Congress that convenes in January 2011, this is an ideal time to reflect on the recent enactment of the Patient Protection and Affordable Care Act of 2010 (PPACA) and how we can ensure a stable U.S. health care system in the future. A key philosophical debate between Republicans, Democrats and other stakeholder groups is whether the government or the private sector is in the best position to help fix the U.S. health care system.Of course, most agree this is not an “either/or” situation – both segments have an important role to play.Unfortunately, the new federal healthcare reform law is dependent on building more government infrastructure than relying on private sector initiatives.

Now that we have had a week to digest the historic election headlines regarding the Republican gains both at the state and federal levels, it is time to move beyond the political whirlwinds and begin to evaluate how we can improve the healthcare system in a meaningful way. BenefitMall has a unique perspective on this as we represent thousands of brokers and agents who help underwrite billions of premium dollars annually.

Addressing the Downpour

Certainly, pitfalls and challenges abound as the U.S. Department of Health and Human Services (HHS) and other federal agencies implement the Patient Protection and Affordable Care Act (PPACA).While outright repeal is unlikely, attempts will be made to roll back or eliminate certain provisions of the Act.Here is a short list of some of the pressure points:

Regarding yesterday’s post, BenefitMall incorrectly posted the newly-elected Republican Governor of Florida. We have updated the information on the blog to show the correct name of the Republican Governor, Rick Scott.

Further, the previously mentioned Marc Rubio of Florida, who is part of the Tea Party movement, will be an addition to the conservative Republican Senators insuring the Senate Democratic leadership will have a more difficult time picking up Republican support to pass any controversial legislation similar to what happened last spring with healthcare reform. With 39 year-old Rubio’s convincing win in Florida, rumors already are spreading that he might be a contender to run for the U.S. Presidency one day. He will be one of many new Congressional members worth watching over the next several years. We apologize for the any confusion related to our earlier post.

During the last few months, the Republican Party has made opposition to President’s Obama’s health care overhaul a central theme in its push to take back the U.S. Congress. While not all of the election returns are final, based on November 2 initial results, change is definitely in the air.

Clearly, some recent headlines are hard to ignore such as “Republicans take over the U.S. House of Representatives” or “Sen. Russ Feingold (D-Wis.) loses bid for reelection to Republican Ron Johnson.” Several other democratic veterans also lost their jobs last night.

State Action

Yet behind the headlines, the fate of health care reform may actually depend more on the outcome of relatively less well-known state races across the country – especially for the offices filled by state insurance commissioners and state legislators.

About BenefitMall

Healthcare Exchange is powered by BenefitMall and designed to serve as a platform for exchanging ideas and finding solutions for healthcare reform. Learn More

At BenefitMall, we have an all together better way of doing business. Working with a network of more than 20,000 Trusted Advisors, Brokers and CPAs, we deliver integrated employee benefits and payroll services to businesses nationwide.